The Positive Effects of Low Carbohydrate and High Saturated Fat Diets on Diabetes

A study was published in 2011 in Current Diabetes Report by Dr. Richard Feinman of the Department of Cell Biology at SUNY Downstate Medical Center in Brooklyn, New York. The title of the study is “Fad Diets in the Treatment of Diabetes.” The abstract is here.

I went ahead and purchased the whole article, and found it very well written. Dr. Feinman clearly understands the effects of refined carbohydrates so prevalent in our modern day diets on blood sugar levels, and as a major contributor to the current type 2 diabetes epidemic in our society. He also clearly understands that the foundation to the lipid theory of heart disease is crumbling as real science shows no relationship to saturated fat consumption and cardiovascular disease (CVD). This is important in dietary advice for those suffering with diabetes, because saturated fats is one of the best food groups to substitute in the place of refined carbohydrates. Feinman states: “The barrier to acceptance of low-carbohydrate diets in the past has been concern about saturated fat, which might be substituted for the carbohydrate that is removed. However, recent re-analysis of much old data shows that replacing carbohydrate with saturated fat is, if anything, beneficial.” This is in obvious reference to the study published in 2010 in the American Journal of Clinical Nutrition titled: “Saturated fat, carbohydrate, and cardiovascular disease.” The researchers who conducted the study seemed to be concerned that the dietary guidelines proposing a reduction in saturated fats was resulting in a higher intake of carbohydrates, which negatively affects health. The study was significant because it was a review of several other studies covering a period of 5 to 23 years of follow-up on 347,747 subjects. Their conclusion: “A meta-analysis of prospective epidemiologic studies showed that there is no significant evidence for concluding that dietary saturated fat is associated with an increased risk of CHD or CVD.” The abstract of this trial is linked to from CoconutOil.com website, and commentary on the study can be found on PubMed here (and many other places around the Internet.)

Dr. Feinman explains convincingly that the “hostility of establishment nutrition” towards low carbohydrate diets shows up not in any science they quote, but in emotional terminology such as “fad diets” when talking about Atkins diets or any other low-carbohydrate diets. Feinman writes:

“Fad” is not a scientific term and is clearly contentious. Conversely, the widely used term “healthy” is also not scientific. The two terms, like positive and negative electrical charge, are probably defined by their being opposites. The real criterion for a fad diet, however, is that you do not like it. Fad diets are the other guy’s diet. This may mean everybody, as in the case of the American Heart Association’s No-Fad Diet, which thinks all other diets are fads. In practical terms, there are two kinds of fad diets: 1) those that have some quirky feature, which hardly anybody adheres to (unlike fads in fashion), and 2) the bête noire of the nutritional establishment, the Atkins diet. Or more generally, any form of low-carbohydrate diet. What rankles researchers is that such diets outperform “healthy” diets for however long they are compared. In diabetes, in which carbohydrate intolerance is more or less the defining feature and some of form of carbohydrate restriction is almost a universal recommendation, attacking low-carbohydrate diets might seem irrational, but it is done often.

Defining fad diets as “diets that do not have scientific backing, that have no underlying principle, and do not perform well in the long term” Feinman cleverly points out that the current nutritional dogma on low-fat diets fits this definition of a fad diet very well. There is no real science behind low-fat science, and the writings of the “father of the lipid theory of heart disease” Ancel Keys have been widely discredited, even back in the 1950s when they were first published. The political action that was taken to promote the low-fat dietary theory came out of Senator George McGovern’s report on the matter, and was written by a young staff member who was a vegetarian. Many researchers were at the hearing, captured on TV by CBS and on YouTube, and objected strongly to the lack of research to back such a dietary philosophy. McGovern’s response: “we Senators don’t have the luxury that a research scientist does of waiting until every last shred of evidence is in.” You can watch it for yourself:

The rest of Feinman’s report is excellent with solid information that I hope many will take the time to read. The real goal Feinman is desiring to accomplish is to attack the problem of diabetes, and not attack other researchers with emotional terminology such as “fad diets.” One of the biggest attacks against carbohydrate restricted diets is the supposed lack of long-term studies on their effects. Dr. Feinman answers this crticism:

It might be said that basic science tends to take a bottom-up approach, placing emphasis on fundamental mechanism, in this case the importance of the glucose-insulin axis, whereas medicine frequently favors a top-down approach favoring long, large-scale trials. I would argue that the nature of diabetes suggests that we start with underlying biochemistry, placing the burden of proof on those who think that the short-term effects of carbohydrate restriction will not persist as long as the diet is adhered to. Along which lines I offer the following real conversation:

Endocrinologist: There are no long-term studies on low-carbohydrate diets in diabetes.

Richard Feinman: Well, let me ask you this. Suppose, for some reason, your patient had gone on the Atkins diet since their last appointment. If they came in having lost weight, with improved HbA1c, improved lipid panel, and you had to reduce their medication, what would you do? Tell them to stop because there are no long-term studies? What would you do?

Endocrinologist: I would tell them to keep doing it.

Richard Feinman: Good call.

Over the last ten years we have now been involved in educating people on the health benefits of coconut oil, we have seen the positive effects coconut oil can have on people with diabetes, especially on a low-carb diet, and we have documented a few of those in this article: Coconut Oil and Diabetes

About the authors: Unlike many people who write about coconut oil by simply reading about it, Brian and Marianita Shilhavy actually lived in a coconut producing area of the Philippines for several years. Marianita Jader Shilhavy grew up on a coconut plantation in the Philippines and in a culture that consumed significant amounts of coconut fat in their diet. She later went on to earn her degree in nutrition and worked as a nutritionist in the Philippines. Brian Shilhavy also lived in the Philippines for several years with Marianita and their 3 children observing firsthand the differences between the diet and health of the younger generation and those of Marianita’s parents’ generation still consuming a traditional diet. This led to years of studying Philippine nutrition and dietary patterns first hand while living in a rural farming community in the Philippines. They are authors of the best-selling book: Virgin Coconut Oil: How it has changed people’s lives and how it can change yours!